Minutes of the Trust Board Meeting Held on 3 March 2016, 2016 at am in the Boardroom, Trust Headquarters Belfast City Hospital

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PRESENT: Minutes of the Trust Board Meeting Held on 3 March 2016, 2016 at 10.

1 PRESENT: Minutes of the Trust Board Meeting Held on 3 March 2016, 2016 at am in the Boardroom, Trust Headquarters Belfast City Hospital Mr Peter McNaney Dr Michael McBride Mrs Miriam Karp, Dr Paddy Loughran Mrs Nuala McKeagney Mr James O Kane Ms Anne O Reilly Mr Martin Dillon Miss Brenda Creaney Dr Cathy Jack Mr Cecil Worthington IN ATTENDANCE: Mr Aidan Dawson Mr Shane Devlin Mr Damian McAlister Ms Catherine McNicholl Mrs Bernie Owens Mrs Jennifer Welsh Ms Claire Cairns Mrs Bronagh Dalzell Mrs Barbara Blair Ms Jill Byrne Dr Damian McCall Mr Bryan Nelson Mrs Joan Pedan Mr Lee Collins, Miss Marion Moffett Chairman Chief Executive Non Executive Director Non-Executive Director Non-Executive Director Non-Executive Director Non Executive Director Deputy Chief Executive/Director of Finance Director Nursing and User Experience Medical Director Director Social Work/Children s Community Services Director Specialist Hospitals and Women s Health (Interim) Director Performance, Planning and Informatics Director Human Resources/ Organisational Development Director Adult, Social and Primary Care Director Unscheduled and Acute Care Director Surgery and Specialist Services Head of Office of Chief Executive Head of Communications Service User Specialist Nurse Consultant Cardiologist, Ambulatory Care Co-Director, Health Promotion Co-Director, Human Resources Leadership Centre Minute Taker APOLOGIES: Professor Martin Bradley Non-Executive Director Dr Val McGarrell Non-Executive Director Mrs Claire Cairns Head of Office 1

2 At the outset of the meeting Mr McNaney, Dr McBride, Mr Dillon and Mr McAlister, spoke with staff holding a silent protest outside the Boardroom in relation to the Single Pay Frequency initiative to move weekly paid staff to monthly pay. Mr McNaney welcomed everyone to the meeting, with a specific word of welcome to Mrs Barbara Blair, a Cardiology Service User. Service User Story Unscheduled and Acute Care Mrs Owens introduced Mrs Barbara Blair, Service User, Ms Jill Byrne, Specialist Nurse and Dr Damian McCall, Consultant Cardiologist, Ambulatory Care. Dr McCall explained that the Cardiology Ambulatory Care Unit (CACU) had opened in August 2015, providing ambulatory emergency care as an alternative option for patients presenting with acute cardiology symptoms. Previously such patients would have been admitted for further investigation and treatment. The service supports the ED offering early referral for access to specialist assessment, diagnostics, treatment and early follow up for identified conditions. Mrs Blair gave an overview of her attendance at the CACU which had been a positive experience, referred to the service not operating at weekends and said there would be benefit for CACU being available 24/7. Having been ill over a weekend she had been admitted to the Ulster Hospital, which she felt could have been avoided had she been able to contact the CACU. Members welcomed the new CACU which was having a positive impact for patients and their families together with clinical staff from the ED and Cardiology Wards. In response to a comment from Dr McBride, Mr Devlin advised that the need for additional investment to extend the CACU service was being raised with the HSCB. Mr McNaney thanked Mrs Blair, Ms Byrne and Dr Damian McCall for their attendance and wished them well for the future. 11/16 Minutes of Previous Meeting The minutes of the previous meeting held on 3 March, 2016 were considered and approved. 12/16 Matters Arising There were no items raised. 13/16 Chairman s Business a. Conflicts of Interests There were no conflicts of interest noted. 2

3 b. Single Pay Frequency Mr McNaney referred to the silent staff protest at the start of the meeting regarding the Single Pay Frequency and acknowledge the difficulties this would present for weekly paid staff. Mr McAlister advised that this was part of the regional Transformation Programme being led by the DHSSPS and the Trust was working with BSO regarding mitigating arrangements to support staff through the process. c. Non Executive Directors Mr McNaney reminded members that both Dr McGarrell and Mr O Kane were due to complete their term in office as Non Executive Directors at the end of March and thanked them for their commitment to the Trust. Mr O Kane thanked Mr McNaney and paid tribute to Trust Board members and finance staff he had worked with over the years. 14/16 Chief Executive s Report a. Emerging Issues i. MMBRRACE Report Dr McBride referred to negative media coverage the Trust had received in relation to the MMBRACE Report published in December He advised that the media coverage had been inaccurate and misleading. Following discussion it was agreed that staff should be invited to make a presentation to the April Trust Board Workshop on the MMBRRACE Report. Mr Dawson advised that staff would welcome the opportunity to clarify the position. ii. Smoke Free Grounds Launch 9 March Miss Creaney reminded members that the Trust would be launching Smoke Free Grounds on 9 March and introduced Mr Bryan Nelson, Co-Director, Health Promotion, who was facilitating the Trust s arrangements. Mr Nelson gave an overview of action being taken by the Trust in preparation for the smoke free launch, including supporting patients/clients to give up smoking. He emphasised that all staff should be advocates for the Trust and challenge anyone seen smoking on Trust property. Mr McNaney welcomed the No Smoking Grounds launch as an important public health message for patients and clients, making facilities healthier. 3

4 15/16 Safety and Quality a. Performance Report Mr Devlin presented the Trust Performance Report for the period ending January 2016, providing an overview of the Trust s position in relation to key standards and targets. The report indicated that of the 41standards and targets the Trust was delivering/slightly behind/expected to achieve the required level of performance in 22 areas. The remaining targets would continue to be a challenge for the Trust to achieve. Miss Creaney referred to the challenges in relation to the Health Care Acquired Infections (HCAI) and explained that HCAI Recovery Plans targeted in certain areas had been put in place to ensure improvement against targets. She emphasised the importance of ensuring a consistent approach to HCAI across the Trust to ensure the Trust remains within target for 2016/17. Mrs Welsh gave an overview of action taken by the Trust to improve performance in the 14 day breast cancer target. A recovery plan was in place to manage the increased level of referrals into the service, whilst dealing with key staff absences. Mrs Welsh explained that the Trust continued to liaise with the HSCB regarding regional capacity issues and the impact of late referrals on the 62 day Inter Trust Transfer (ITT) target. It was noted that there would be a detailed presentation on Cancer Targets at the April Trust Board Workshop. Mrs Owens referred to the Unscheduled Care performance and advised the Trust continued to strive for improvement in ED provision. In response to a comment from Mr O Kane regarding the significant increase in patients waiting 12 hours in January, Mrs Owens advised that there had been an overall 8% increase in attendances in RVH, ED, the new systems meant that overall the system can recover quicker. Dr McBride said that RQIA feedback following the last visit had reflected system improvements for patients and staff morale. Mr McNaney asked that a review of Winter Pressures and related service improvements be presented to a future Trust Board workshop. Mr Devlin advised that due to the additional funding being made available to address waiting lists the Trust had secured additional in house and independent sector capacity for elective patients. However, due to capacity issues it may not be possible to spend the allocation in full prior to the end of the financial year. In response to a question from Mrs McKeagney regarding the Out-Patient 9 week target performance, Mr Devlin advised that in addition to capacity issues in some specialities, there was a need for significant investment. He advised that the Trust had established an Out-Patient Modernisation project focusing on streamlining patients pathways and maximising use of technology. 4

5 Ms McNicholl referred to the challenges in meeting Mental Health and Learning Disability discharge targets, due to insufficient community and housing capacity. In noting the Performance Report, Mr McNaney stated that there was a need for more realistic Ministerial targets as currently due to capacity issues there are targets that are outside the control of the Trust consistently reporting as unachievable. b. Regional Emergency Social Work Service Annual Report 2014/15 Mr Worthington presented the Regional Emergency Social Work Service Annual Report , providing statistical information on referrals into the service across all social care service areas. He advised that the Social Care Committee (SCC) had considered the report on 23 February Ms O Reilly that the SCC was content to commend the report to Trust Board and paid tribute to the Mrs Carol Diffin, Co-Director, Child Health Services, for her leadership of the regional service. Members considered and approved the Regional Emergency Social Work Service Annual Report for 2014/15. c. Adoption Services Annual Report 2014/15 Mr Worthington presented the Adoption Services Annual Report 2014/15, which provided an overview of the key areas pertaining to the delivery of a statutory service to adult and children involved in the adoption process, including post adoption support, which had been considered in detail by the SCC on 23 February Mr Worthington advised that whilst the Trust had managed the Adoption Service regionally, the HSCB had agreed to a request from the South Eastern Trust (SET) to manage their own adoption service and the Trust was currently providing advice and support to SET regarding this. Members expressed concern at the decision to split the Adoption Service in relation to the risk of governance and accountability issues. Mr Worthington undertook to feedback these concerns to the HSCB. Ms O Reilly acknowledged the very specialist area of work within the Adoption Service in line with complex legal requirements and paid tribute to all staff involved in the delivery of the service. She advised that the SEC would recommend the report to Trust Board. Members considered and approved the report. d. Organisational Development Strategy 2015/25 Mr McAlister introduced Mrs Joan Peden, Co-Director and Mr Lee Collins, Leadership Centre. 5

6 Mrs Peden and Mr Collins gave a presentation outlining the process undertaken in the development of the Trust s Organisational Development (OD) Framework. The OD Strategy outlines the means by which the Trust will become recognised as a local, national and international leader of excellence in Health and Social Care. Members noted the OD framework the three organisational workstreams/ priorities which the Thrust will seek to fulfil its ambition to become a leader in excellence, i.e. Safety and Quality; Research and Innovation; and Collective Leadership. The OD framework will be governed by the establishment of an OD Programme Board, chaired by the Chief Executive and drawing on representatives from internal and external organisations. Ms O Reilly welcomed the OD Strategy and the commitment to stakeholder involvement throughout the strategy. Mrs McKeagney congratulated all staff involved in the development of the OD and asked that Non Executive Directors be included in the training programme. She also asked that Trust Board receive regular updates on progress. In response to a question from Mr McNaney, Mr McAlister advised that the OD Strategy would be launched at the Leadership Conference on 22 April 2015, thereafter an engagement exercise would be carried out to ensure the OD culture is embedded within organisation. Mr McNaney said the OD would benefit from having some form of branding, Mr McAlister undertook to consider this. Following a lengthy discussion the Organisation Development Strategy for 2015/25 was approved. 16/16 Deputy Chief Executive/Director Finance, Estates and Capital Development a. Finance Report Mr Dillon presented the Finance Report for the period ending January 2016 indicating a deficit position of 0.4m due to non-recurrent funding from HSCB and improved performance. He was pleased to report that it was anticipated that he Trust would achieve financial breakeven by the end of the financial year. Mr. Dillon advised that the Trust had submitted the draft financial plan for 2106/17 and following a number of minor revisions, has identified a potential gap between anticipated spend and the HSCB s indicative funding allocation of almost 55m subject to the 2015/16 approved savings plan being delivered in full. This gap includes a recurrent underlying gap of 16.6m, a shortfall of 3.6m against the Trusts 2015/16 savings target and a 2016/17 funding gap relative to anticipated expenditure. The Trust is continuing to negotiate with 6

7 the HSCB and DHSSPS for funding to be allocated to meet the 16.6m underlying gap in order to achieve equity with other Trusts. Mr McNaney acknowledged the enormous amount of work undertaken in order to achieve the financial breakeven and wished to thank all staff involved. Members noted the finance report. 17/16 Assurance Committee Mr McNaney presented the minutes of the Assurance Committee meeting held on 17 November 2015 for information. Members noted the content of the minutes. 18/16 Social Care Committee a. Terms of Reference Mr Worthington presented the proposed Terms of Reference for the Social Care Committee. Members considered and approved the Terms of Reference. b. Minutes 7 January 2016 Ms O Reilly presented the minutes of the Social Care Committee meeting held on 7 January 2016 for information. Members noted the contents of the minutes 19/16 Any Other Business There were no items raised. 20/16 Date of Next Meeting Members noted the next meeting of Trust Board was scheduled for 5 May

TB Minutes of the Previous Meeting The minutes of the Trust Board Meeting held on 10 December were read and approved.

TB Minutes of the Previous Meeting The minutes of the Trust Board Meeting held on 10 December were read and approved. Minutes of the 19 th Trust Board Meeting held on 21 st January 2010 at 10.00am, in Room One, Central Dining Hall, Knockbracken Healthcare Park Present: Mr P McCartan Mr W McKee Professor E Evason Ms J